Cerebral tissue oxygenation index and superior vena cava blood flow in the very low birth weight infant.
BACKGROUND
Superior vena cava (SVC) flow assesses blood flow from the upper body, including the brain. Near infrared spectroscopy (NIRS) provides information on brain perfusion and oxygenation.


OBJECTIVE
To assess the relationship between cerebral tissue oxygenation index (cTOI) and cardiac output measures in the very low birth weight (VLBW) infant in the first day of life.


METHODS
A prospective observational cohort study. Neonates with birth weight less than 1500 g (VLBW) were eligible for enrollment. Newborns with congenital heart disease, major congenital malformations and greater than Papile grade1 Intraventricular Haemorrhage on day 1 of life were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Low SVC flow states were defined as a flow less than 40 mL/kg/min. cTOI was measured using NIRO 200 Hamamatsu.


RESULTS
Twenty-seven VLBW neonates had both echocardiography and NIRS performed. The median (range) gestation was 29/40 (25 + 3 to 31 + 5 weeks) and median birth weight was 1.2 kg (0.57-1.48 kg). The mean (SD) TOI was 68.1 (7.9)%. The mean (SD) SVC flow was 70.36(39.5) mLs/kg/min. The correlation coefficient of cerebral tissue oxygenation and SVC flow was r = 0.53, p-value 0.005. There was a poor correlation between right and left ventricular output and cTOI which is not surprising considering the influence of intra- and extracardiac shunts.


CONCLUSIONS
There is a positive relationship between cerebral TOI values and SVC flow in the very low birth infant on day one of life.
Moran
M
M
Department of Pediatrics and Newborn Medicine, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
Miletin
J
J
Pichova
K
K
Dempsey
E M
EM
D001921:Brain / Q000098:blood supply*; D002552:Cerebral Ventricles / Q000098:blood supply; D002560:Cerebrovascular Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D012039:Regional Blood Flow; D012307:Risk Factors; D019265:Spectroscopy, Near-Infrared; D014683:Vena Cava, Superior
D010100:Oxygen